How to Manage Embarrassment, Blame Guilt and Shame 1 of 3Mar 13, 2022
We all have a deep longing to be seen and accepted for who we are.
If you have a child learning to manage OCD, you know this is a tall order. One of the big worries is, “What would people think about me if they could see my life?“
Your child might wonder: Would you be my friend— even if you knew about my dark thoughts and crazy rituals? Would you hire me— even if you knew about my OCD?
As a parent, you might wonder: Would you see me as a competent parent—even if you saw the chaos in my home?
In the next blog posts, I’ll offer tips to help you and your child more effectively manage embarrassment, blame, guilt and shame.
The Evolution of Disease Management
When I was 4 or 5, I met my Aunt Beverly. I remember her as an intelligent, kind person with an inviting smile. On the drive back from Nanny Leah’s lake home, I asked my parents where Aunt Beverly lived, thinking she might live far away like Aunt Marion did. My mom told me Aunt Beverly lived in an adjacent town. I was confused. If it was only an hour drive, whey didn’t we see her more often. My mother turned around and told me in a whispered voice, “Aunt Beverly has ‘fits’.”
What my mother meant is that Aunt Beverly had a seizure disorder. Back then this considered to be a shameful condition. The doctors persuaded my grandparents to institutionalize her.
Thirty years later I treated a patient Yvonne. I walked into the exam room to find a beautiful golden retriever sitting at my patient’s feet. I asked, “Who’s this?”. She said, “Oh, this is Shaker. She’s my seizure alert dog.” Yvon and I had conversations about what it was like for her to live with a seizure disorder.
She lived with her husband and Shaker. She had friends. She went shopping and visited the library. She doesn’t drive, so she gets around by taxi. She told me that occasionally she has seizures in public. She said that she used to be embarrassed but she’s gotten over that. Now her biggest challenge is reassuring the people who get embarrassed when they witness her seizures.
All in all, Yvonne’s life looks very much like mine or yours.
Why did Aunt Beverly and Yvonne have such different lives? They were dealing with the exact same medical condition. Sure, medications improved over the years. However, the major difference was the story people told about the medical condition.
The shame around the seizures was the thing that eroded my aunt’s quality of life and contributed to my aunt’s suffering.
You Don't Die of Snake Bites
The seizure disorder is like a snake bite.
People don’t die of snake bites; they die from venom poisoning.
The shame about seizure disorders was like the snake venom.
Your child with OCD has a specific brain wiring glitch. That’s their snake bite.
The most profound harm comes not from the OCD itself but from the stories people tell about OCD. The embarrassment, blame, guilt and shame are the venom. They are the source of collateral damage of OCD.
The amount of collateral damage and suffering is directly tied to the way we manage embarrassment, blame, guilt and shame.
I’ll break this down into three sections. In the first , I’ll talk about the biology of behavior and specifically the biology of OCD. This will help you understand the origins of embarrassment, blame, guilt and pain.
Then we’ll take on embarrassment.
Last, we’ll take on guilt, blame and shame.
The Biology of Behavior
Let’s dig in to the biology of behavior. The COVID pandemic reignited my interest in this topic, and underscores the relevance of understanding our brains today.
We are a tribal species. We divide ourselves into groups of like-minded people. The COVID pandemic helps us understand how much we value the ability to physically gather with other tribe members.
The number one job of both your brain and your tribe is keep you alive. Safety is the highest priority.
Your Brain Keeps You Safe
Our brains are designed to constantly be scanning the environment for potential danger. The oldest part of our brains—our reptile brains have a repertoire of behaviors when life and death is on the line. We get ready to fight, flee, freeze or fawn. without a single conscious through on your part.
If your brain were in charge of your life, it would want you to just stay on the couch instead of taking risks. It’s safe there. Your brain would also say, “Sure, go ahead and eat Cherry Garcia ice-cream as you binge watch Netflix.” That way you’re both safe and comfortable.
If you want something more in your life—whether it’s getting fit or falling in love or starting a business, your biggest barrier to success may well be this brain wiring designed to keep you safe.
OCD = Turbocharged Danger Detectors
Our kids with OCD have turbocharged danger detectors. Imagine how you would feel if you woke up and found a masked stranger at the foot of your bed. This is what life is like for them. A brain wiring glitch generates highly disturbing throughs and images. These obsessions trigger the reptile brain and leads to high levels of anxiety.
Over time they learn that they can bring their anxiety back down to normal by doing rituals called compulsions.
OCD is treatable. Our kids learn how to manage their brains. It’s simple but not easy.
Let’s say your son has the recurrent thought that he will stab the beloved family dog. First he announced that he would no longer feed or walk the dog. Then he left the room when the dog came to sit with him. Then he started avoiding dogs in public. If he sees a dog on the street he turns the other way. He just asked you to lock up the knives in the house.
Your child knows that this is irrational behavior. He knows he would never harm his 4-legged best friend. He avoids dogs because the OCD monster that lives in his head tells him to do it. Or else. OCD rituals are a form of self-sacrifice done in the spirit of keeping dogs or people or the world safe.
Tribes Keep Members Safe
If brains keep individuals safe, tribes keep groups safe. Prairie dogs gather in large extended families. When the prairie dog guard sounds an alarm, all the family members rush to safety.
We, too, respond when we see danger alarms even if we don’t see the danger. If you see someone running down the road, you can tell the difference between someone exercising and someone fleeing from danger. If someone is fleeing your body gets ready to flee without a single conscious thought from you.
As Yvonne points out, the people who witness something embarrassing can also experience embarrassment. Panic and embarrassment can be catchy so that all the tribe members can enjoy the safety benefit.
Tribes Have Laws of Etiquette
Tribes have laws of etiquette that all members know. You bring a present when you’re invited to a birthday party. If you hurt someone, you say, “I’m sorry.” You try not to burp in public.
Embarrassment is a feeling you get when you know that you violated a law of etiquette. Your red face signals to others around you, “Yes. I made a mistake. I know it and now I’m announcing that to you!”
Tribes Have Rules
Tribes also have rules members are expected to obey. We drive at the speed limit and we know the consequences of ignoring it. We pay taxes. We saw tribal differences in mask-wearing and vaccination.
There was a time in which there was a rule that said, “If you’re around someone who sneezes you say, “God bless you.”
Some say that in ancient times, people believed that sneezing would allow evil spirits to enter your body. Saying “God bless you.” kept out those evil spirits.
Others give credit to Pope Gregory the Great who believed that a sneeze was an early sign of plague. He commanded Christians to respond to a sneeze with a blessing. The power of prayer in illness is still being explored.
Now saying bless you is a law of etiquette. It would feel odd if you sneezed and no one said, “Bless you.” In certain places including China, Japan, Vietnam and Korea, the response to a sneeze is either silence or an expression of concern if the person looks sick.
I noticed that in the early months of the COVID pandemic, I tried my best not to sneeze in public. I had a heightened awareness of who cover their coughs and sneezes and who did not.
Tribes Have Ways of Dealing with Mistakes
The tribe has ways of dealing with people who make mistakes or break the rules. Some mistakes are tolerated; tribe members get second chances. Other mistakes are punished.
Guilt is a self-imposed punishment for our mistakes.
Expulsion is the most feared and dreaded tribal punishment. Blame and shame are ways to avoid these dire consequences of our mistakes.
Shame is a strategy of hiding, in hopes that you will not be found out. Many kids managing OCD live with shame. Secrecy and shame are toxic for our kids. Shame makes it harder rather than easier to get to the other side of OCD when your child is in the drivers seat of his or her life. I recommend that you put shame on your absolute NO list.
Blame says, “I didn’t do it. Don’t punish me.” When my brother and I grew up, my mother wanted to know, “Who broke this.” My brother and I pointed the finger at each other. My mother wanted to get to the bottom of it, so she said both of us would be punished until the truth came out. The punishment was that we couldn’t watch Batman and that was a terrible punishment.
I recommend that you put blame with shame on your absolute NO list.
Tribes Have Ways of Staying Healthy
The overall health of the tribe needs to be preserved. Wisdom gets passed down throughs the generations. “This berry is safe to eat; that berry is dangerous.”
In the pre-antibiotic era, tribes stayed healthy by preventing illness; the rule was to avoid sick people.
How do you know that someone is sick?
We already talked about people who sneeze.
You could tell if someone is sick by looking at their skin. Even the bible mentions what to do with people who have a specific skin disorder medical historians think was leprosy. You could die if you had contact with small pox.
Today people with skin disorders like acne say they feel ostracized. There’s a TV ad for a medication that treats psoriasis. The message? Take this medication and you don’t have to hide any more. Why would a person with psoriasis need to hide? Now we know that you can’t catch psoriasis.
We’re making progress. You might have seen the model with vitiligo—a condition in which patches of skin loses pigment cells This leads to discolored patches in different areas of the skin.
You could tell if someone’s sick by looking at the way they walk. I often wondered why the elderly resist carrying a cane or using a walker when a hip fracture could mean early death. Then a patient Ben told me his story. He lived through the polio epidemic. His brother caught it and recovered, but had problems walking for the rest of his life.
Once Ben’s brother was seen on the street with a cane, things changed for Ben. Ben’s best friend told him that his mother wouldn’t let him go to Ben’s house any more and Ben was no longer welcome in his house. I wonder whether on a deep level the elderly fear that they will be ostracized if they use a cane just like kids were during the polio epidemic.
Again, we’re making progress. Now people who use wheelchairs can access places that were closed to them in the 60’s.
You could tell if someone’s sick by looking at the way they act. Rabid animals pose a health risk; they could turn on you and you could die a painful death. Bats can carry rabies. Could this explain our visceral fear of bats?, I wonder if 100 years ago people looked at someone with a seizure disorder or Down syndrome or even a stutter and worried about a rabies variant.
The rituals seen in OCD certainly fall in the category of eccentric behavior.
Imagine you see someone in the parking lot at the mall. Instead of just unlocking the car door and getting in, a woman makes three counterclockwise revolutions around the car, does 7 push-ups, then makes three clockwise rotations followed by 7 burpees. That’s if she’s a passenger. If she’s a driver, she doubles those numbers. Further, she won’t park next to a car with a license plate that ends with an odd number.
That looks like crazy behavior. The person with OCD going through these rituals would agree. This is crazy behavior. They want to give it up.
So, why do they do it?
It’s because of their OCD brain wiring glitch. Here’s what it’s like.
What is OCD Like?
During a holiday week end, my driver’s side window would not go up. My car worked fine; there was just problem with the window. But if the window didn’t go up I couldn’t lock my car. That meant I would take a risk every time I parked anywhere except my locked garage.
Fortunately a friend shared a quick fix so I could drive. It involved pounding on the open door with the window lever in the up position. The window went up! She said, “Now just don’t lower that window. You might forget so you want to put tape over the window switch. Then on Tuesday you can bring your car in and get the window switch fixed.”
This is a perfect metaphor for OCD. OCD is caused by a specific wiring glitch in the brain. Your kids’ thoughts get stuck in dark places, just like my car window got stuck. This can have impacts on every part of life, just like my inability to lock the car impacted my ability to drive to most places. Treatment involves helping your child avoid the OCD neural pathways, just like I was instructed not to lower the window. Once your child learns how to avoid this neural pathway, the rituals will no longer be needed.
Do you see how this explanation takes the sting out of the behaviors that trigger embarrassment? The goal is to replace, “I’m so embarrassed about my car ritual. I just won’t drive ” with “Yup. Right now I have a car ritual. I do it because my brain has a wiring glitch. I’m working on it, and one day I’ll be able to just get in my car and drive. In the meantime, I know this is not about me; it’s about the OCD wiring glitch.”
One of the challenges that keeps your child in hiding is that the tribe —including the tribe of healthcare professionals—treats medical conditions of the brain differently than medical conditions of any other organ in the body.
How many medical conditions are diagnosed without an imaging study or lab test? Can you imagine an oncologist saying, “Yup that sounds like lung cancer. Let’s start this aggressive treatment.” Yet, the standard of care is for OCD to be diagnosed by somebody listening to the story.
Would the families of kids going through chemotherapy be embarrassed about a hairless head like families living with OCD are embarrassed by car rituals? No. If a family member has cancer, people around them often shave their heads in solidarity.
A big part of your ability to get through OCD is proactively managing what you think, feel and believe about OCD.
OCD is the snakebite; poorly managed embarrassment, blame guilt and shame are the venom.
Remove the Venom
If you want to take the venom out of OCD, I invite you and your family watch a documentary called Life According to Sam. It’s an inspirational documentary about a boy Sam Berns and his family. Sam has progeria. This is a condition in which the body has accelerated aging.
At the beginning of the film, Sam turns to the camera and says, “I didn’t put myself in front of you to have you feel bad for me. I put myself in front of you to let you know you don’t need to feel bad for me. I want you to know me. This is my life, and progeria is part of it. It’s not a major part of it, but it is part of it.”
As you watch the movie, you’ll see what things can be like without the venom flowing.
Imagine how different your life could be if you embraced the lessons Sam and his family shared.
Let me close this episode with some good news.
The beliefs of our tribe matter. Today we live in a more inclusive society. People with differences are coming out of hiding. The Good Doctor is a TV show about a doctor on the autism spectrum. Edward Norton portrayed a character with Tourette’s syndrome in Motherless Brooklyn.
Your child may feel that he or she needs to hide until they do a better job of managing OCD.
This is like saying that you have to be in better shape before you go to the gym.
Hiding makes OCD worse—not better. Hiding makes things more dangerous—not safer—for our kids. Secrecy leads to shame that leads to growing OCD.
As more people “come out”—not as being gay but rather as someone learning to manage this OCD brain wiring glitch, good things happen.
You can find a tribe today where it’s safe for you to be who you are and where it’s safe for your kids to be who they are.
The more people who come out of hiding with OCD, the easier it will be for everyone.
It will accelerate the transition from the OCD equivalent of my Aunt Beverly’s world to the equivalent of my patient Yvonne’s world.
In the next blog post, we’ll talk about how to manage embarrassment more effectively.
Please feel welcome to share this blog post with your child. Ask what he or she things.
Feel welcome to also share it with people who are there to support your child. Your child’s champions might including family, friends and teachers.
I’m pleased to announce we are about to launch our course for the people who want to join the ranks of OCD PowerParents. While all parents are welcome, we’ll focus on parenting a child with OCD, car keys and credit cars. Click here to get on the waiting list and be the first to know the we open it, you can sign up below.
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I’m sorry in advance if you reach out and all the 1:1 coaching seats are filled. if you’re interested in making a transition from just treading water to getting back to the joy in life, act quickly!
Thanks again for reading this! You can do this! Your child can do this!
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